Do blood tests reveal early warning signs for inflammatory bowel diseases?

In a groundbreaking discovery, researchers at the Francis Crick Institute and Aalborg University in Copenhagen have identified subtle yet significant changes in blood tests that can precede a diagnosis of Crohn's disease by up to eight years and ulcerative colitis by up to three years.

IBD, encompassing Crohn's disease and ulcerative colitis, is characterized by excessive inflammation in the gut, leading to debilitating symptoms such as abdominal pain and diarrhea. Early diagnosis and treatment are crucial for improved outcomes.

To unveil the signs of these diseases in their nascent stages, the research team harnessed electronic health records from individuals in Denmark, conducting a comprehensive analysis of 20,000 IBD patients in comparison to 4.6 million controls without IBD.

A decade of pre-diagnostic test results was examined, uncovering alterations in a range of indicators, including blood minerals, blood cell composition, and inflammatory markers like faecal calprotectin. This molecule is released into the gut during inflammation and is presently used to determine whether individuals with bowel symptoms require further investigations.

Remarkably, these changes were noticeable up to eight years before a Crohn's disease diagnosis and up to three years before ulcerative colitis diagnosis. Most significantly, these changes were subtle and typically fell within standard blood test parameters, making them challenging to detect. Only the utilization of extensive datasets allowed the researchers to identify these changes across various markers.

Reference: Characterising the pre-clinical phase of inflammatory bowel disease., Cell Reports Medicine

DOI: 10.1016/j.xcrm.2023.101263